bear. An excessive quantity of morphia given by the mouth may be removed if the accident is discovered immediately, but the only resource in case of excessive injection lies in antidotes, the operation of which is very uncertain. According to the collection of facts on this subject which has been published by Dr. Kane, of this city, the smallest single dose which has appeared to have alone been the cause of death was a quarter of a grain. In a case in which death apparently resulted from the administration of a twelfth of a grain by the skin, a quarter of a grain had previously been given by the mouth. In three of the cases cited by Dr. Kane, including one in which a quarter of a grain caused death, the patients were suffering from delirium tremens; in the majority of the cases the fatal effect was due to the repetition of the hypodermic injection, or to its employment after a fair dose of opium had been given by the mouth. It is impossible to predict, or to estimate with any approach to safety, what the effect of an injection will be. Tolerance of opium by the mouth does not prove that it will be tolerated equally well by the skin; and tolerance of morphia by hypodermic injection at one time is no ground for inferring that at another time the same dose would be equally well borne. The use of morphia is peculiarly dangerous in certain morbid states, foremost among which is alcoholism. The existence of chronic Bright's disease increases the danger, as does also the existence of disease of the heart or lungs, interfering with circulation and respiration. The fact also seems to be established that the existence of severe pain does not render large doses better borne. Atropine is capable to some extent of counteracting the influence of morphia, but can not be relied upon alone. It needs to be supplemented by other remedies, and is assisted by the hypodermic injection of strychnia. It also will kill, and should not be used in a larger proportion than one twenty-fifth of a grain of atropine to every grain of morphia. Strychnia should not be used in a larger total quantity than one twentieth of a grain, and a much smaller dose should be first administered. Artificial respiration, electricity, and coffee or caffeine, remedies in common use, may also be necessary in addition. Whenever there is reason to think that the injection has been directly into a vein, the circulation in the limb should be arrested by a ligature above the place of injection; and the "Lancet" suggests that it is possible, when the fact of an overdose is at once discovered, that something may be done by local treatment to arrest absorption. The whole of the morphia can hardly be taken up instantaneously, and it is probable that, if a ligature were at once placed on the limb, an incision made through the skin at the seat of the injection, and the part freely washed, or even freely cauterized, the amount of morphia absorbed might be reduced to so small a degree that it would be possible to antagonize it, and thus save the patient's life.
Sanitary Perils at Watering-Places.—The "Lancet" has uttered a warning against the sanitary dangers to which populous health resorts are liable, which receives support from several incidents that have happened within a few years past. It is incumbent upon every one who goes to the seaside, to take care that he does not leave a comparatively healthy home to seek recreation in a place which may be a nursery of disease. Watering-places are peculiarly liable to have two kinds of perils: to the danger that infection may be brought to them by visitors, and to the risks that may arise from the insufficiency of their sanitary arrangements to meet the demands that are made upon them by the accession of large crowds. It has sometimes happened that, as soon as a child has become convalescent from an infectious disease, it has been hurried off to the seaside, and been received at lodgings without question. The sanitary precautions now carried out at many places make this a matter of more difficulty than formerly, but the danger is still hardly diminished that arises from sending off the unaffected members of an affected family to the seaside as soon as contagious disease breaks out. The "Lancet" tells of a case as having come under its own notice, in which, when a child was taken ill with a sore-throat of a suspicious character, another child in the family was sent to the seaside, was taken ill with diphtheria on the day after his arrival, and communicated the disease to other children with whom he had played. When disease breaks out in the height of the season, the fact is apt to
